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High Energy ESWT for PF after Low Energy Unsuccessful?

Posted by Paul F on 7/02/03 at 20:40 (123474)

I had two sets of three low energy ESWT treatments about nine months apart for medial insertion PF. In both cases, my PF improved, but then gradually returned, although not to its most painful levels. So I guess my pain levels are down about 50% overall. Will a high-energy treatment help?

I also have inflammation in the achilles, at the back of the medial PF insertion point. I had a set of three low energy treatments for this but there was no change in the pain, tenderness or inflammation, either immediately after the procedure or later on. Will a high-energy treatment possibly help this?

How useful is the in-line ultrasound when a high-energy treatment is done? I believe the Dornier EPOS has this.

Re: High Energy ESWT for PF after Low Energy Unsuccessful?

Dr. Z on 7/02/03 at 20:42 (123475)

Hi

The dornier outline ultrasound is able to locate the pain at the insertional area of the plantar fascia. So long as there is trigger point pain at the insertion,then the high ESWT dornier can reduce your pain even more. Do you have pain when you sit for any length of time and then get up ?

Re: High Energy ESWT for PF after Low Energy Unsuccessful?

Paul F on 7/02/03 at 20:50 (123477)

There's usually a little bit more pain the first thing in the morning, but I haven't noticed it after getting up after sitting for a long stretch.

Re: Trigger Point Pain

Paul F on 7/02/03 at 20:52 (123478)

Yes, there's a tender area at the medial insertion point. I think that's what you mean by trigger point pain.

Re: How Long To Wait

Paul F on 7/02/03 at 20:59 (123479)

Dr. Z,

My last set of Siemens Sonocur ESWT treatments for PF were done in January. Should I wait longer before having a high-energy treatment?

Re: High Energy ESWT for PF after Low Energy Unsuccessful?

Dr. Z on 7/02/03 at 21:16 (123480)

You need to have an examination. IF you have trigger point pain on palpation and the ultrasound evaluation is abnormal you should get improvement in most cases

Re: How Long To Wait

Dr. Z on 7/02/03 at 21:17 (123481)

Hi
Six months is plenty of time, especially if you see no improvement or a regression of improvement

Re: High Energy ESWT for PF after Low Energy Unsuccessful?

Ed Davis, DPM on 7/02/03 at 21:40 (123484)

Paul:

What was the reason that there was 9 months in between the two sets of treatment?

It is possible that any form of ESWT, high or low energy, may bring you to a higher level of relief. Nevertheless, it is important that you are treating any other causes of plantar fascia. Few treatments for PF are stand alone treatment, so if there are causes that are not completely treated, recurrence is more likely.

Ed

Re: Dr. Z, Question ????

BrianG on 7/04/03 at 09:23 (123562)

Hi Dr. Z,

Just wondering if you have ever used your Dorier for 3 low energy treatments, instead of the FDA recommended high energy, one treatment?

Happy 4th
BrianG

Re: Dr. Z, Question ????

Dr. Z on 7/04/03 at 09:30 (123563)

I used it for non-insertional chronic achilles tendonitis.